"There are far too many children, especially very young children, who suffer serious injuries from child abuse and are hospitalized for the care of these injuries," said study author Dr. John Leventhal, a professor of pediatrics at Yale School of Medicine and a pediatrician at Yale-New Haven Hospital.

Leventhal and colleagues compared the characteristics of children hospitalized because of abuse, including age and insurance status, to those of children hospitalized for reasons other than abuse, such as accidental injuries or illnesses. Among the findings, published today in the journal Pediatrics, abused children of all ages were more likely to be covered by Medicaid.

"In our study Medicaid was a proxy measure for poverty, and poverty increases the stress in people's lives," said Leventhal. "But it's important to note that any parent could lose it."

The rate of death due to abuse was six times higher than the rate of death among children hospitalized for non-abusive injuries or illnesses, and the average length of stay in the hospital was almost double at just over a week.

The study highlights the heavy burden of abuse among the country's most vulnerable citizens.

"The worst is when these kids die," said Leventhal. "Clearly those families are destroyed. Some people go to jail, and that's a heartache too. Sometimes children are placed with a relative or in foster care. Of course, there's heartache there, too."

Child abuse carries a heavy cost, too. The average hospital stay cost $16,058, compared with $9,550 for non-abuse-related injuries and $7,964 for other illnesses, bringing the national cost of abuse-related hospitalizations to $73.8 million -- a fraction of the estimated $124 billion spent on justice, education, health care and social support for children who survive abuse and neglect, according to the U.S. Centers for Disease Control and Prevention.

"We're not messing around with small things here, this is on par with the cost of type 2 diabetes in this country," said Leventhal. "Never mind the heartache for the kids and families."

"The hospital costs are just for the things we can see," said Dr. Lolita McDavid, a child advocate at Rainbow Babies and Children's Hospital in Cleveland. "Oftentimes these children have to go into foster system or long-term care, and that's above and beyond cost of hospitalization. That's the cost of having somebody who can't be productive and hold a job. These people may need special assistance for the rest of lives."

McDavid and Leventhal agree that investing in programs aimed at preventing child abuse could save heartache as well as tax payer money in the long run.

"I think people are realizing it's 'pay me now' or 'pay me later,'" said McDavid. "We have to identify parents early in pregnancies and make sure they're learning about parenting skills. We have to identify families who are at risk."

Leventhal said the number of children hospitalized because of child abuse represents less than 2 percent of the total number of abused children reported by child protective services.

The incidence of abuse leading to hospitalization in babies under 1 year old surpassed that of sudden infant death syndrome or SIDS, which dropped dramatically with the launch of the National Institute of Child Health and Human Development's "Back to Sleep" campaign in 1994.

"Because of that campaign, every new mother and father is told babies should be put on backs and their cribs should have no bumpers and no soft pillows. This reduced the incidence of SIDS by about 50 percent," said Leventhal. "We need a national child abuse campaign."